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Overlapping dimensional phenotypes of impulsivity and compulsivity explain co-occurrence of addictive and related behaviors

  • Jeggan Tiego (a1), Sanne Oostermeijer (a1) (a2), Luisa Prochazkova (a1) (a3), Linden Parkes (a1), Andrew Dawson (a1), George Youssef (a1) (a4) (a5), Erin Oldenhof (a1), Adrian Carter (a1), Rebecca A. Segrave (a1), Leonardo F. Fontenelle (a1) (a6) (a7) and Murat Yücel (a1)...



Impulsivity and compulsivity have been implicated as important transdiagnostic dimensional phenotypes with potential relevance to addiction. We aimed to develop a model that conceptualizes these constructs as overlapping dimensional phenotypes and test whether different components of this model explain the co-occurrence of addictive and related behaviors.


A large sample of adults (N = 487) was recruited through Amazon’s Mechanical Turk and completed self-report questionnaires measuring impulsivity, intolerance of uncertainty, obsessive beliefs, and the severity of 6 addictive and related behaviors. Hierarchical clustering was used to organize addictive behaviors into homogenous groups reflecting their co-occurrence. Structural equation modeling was used to evaluate fit of the hypothesized bifactor model of impulsivity and compulsivity and determine the proportion of variance explained in the co-occurrence of addictive and related behaviors by each component of the model.


Addictive and related behaviors clustered into 2 distinct groups: Impulse-Control Problems, consisting of harmful alcohol use, pathological gambling, and compulsive buying, and Obsessive-Compulsive-Related Problems, consisting of obsessive-compulsive symptoms, binge eating, and internet addiction. The hypothesized bifactor model of impulsivity and compulsivity provided the best empirical fit, with 3 uncorrelated factors corresponding to a general Disinhibition dimension, and specific Impulsivity and Compulsivity dimensions. These dimensional phenotypes uniquely and additively explained 39.9% and 68.7% of the total variance in Impulse-Control Problems and Obsessive-Compulsive-Related Problems.


A model of impulsivity and compulsivity that represents these constructs as overlapping dimensional phenotypes has important implications for understanding addictive and related behaviors in terms of shared etiology, comorbidity, and potential transdiagnostic treatments.


Corresponding author

*Correspondence regarding this article should be addressed to Jeggan Tiego, Brain and Mental Health Research Hub, 770 Blackburn Road, Clayton, Victoria 3800, Australia. (Email:


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Jeggan Tiego and Sanne Oostermeijer are both first authors.



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1.Morris, LS, Voon, V. Dimensionality of cognitions in behavioral addiction. Curr Behav Neurosci Rep. 2016;3(1):4957.
2.Hollander, E, Rosen, J Obsessive-compulsive spectrum disorders: a review. In: Maj M, Sartorius N, Okasha A, Zohar J, eds. Obsessive-Compulsive Disorder. 2nd ed. West Sussex, UK: John Wiley & Sons Ltd.; 2002:203224.
3.Fineberg, NA, Potenza, MN, Chamberlain, SR, et al. Probing compulsive and impulsive behaviors, from animal models to endophenotypes: a narrative review. Neuropsychopharmacology. 2010;35(3):591604.
4.Black, DW. Compulsive buying disorder: a review of the evidence. CNS Spectr 2014;12(2):124132.
5.Fineberg, NA, Chamberlain, SR, Goudriaan, AE, et al. New developments in human neurocognition: clinical, genetic, and brain imaging correlates of impulsivity and compulsivity. CNS Spectr 2014;19(1):6989.
6.Krueger, RF, DeYoung, CG. The RDoC initiative and the structure of psychopathology. Psychophysiology. 2016;53(3):351354.
7.Kotov, R, Krueger, RF, Watson, D, et al. The hierarchical taxonomy of psychopathology (HiTOP): a dimensional alternative to traditional nosologies. J Abnorm Psychol. 2017;126(4):454477.
8.Robbins, TW, Gillan, CM, Smith, DG, de Wit, S, Ersche, KD. Neurocognitive endophenotypes of impulsivity and compulsivity: towards dimensional psychiatry. Trends Cogn Sci. 2012;16(1):8191.
9.Krueger, RE, Markon, KE. Reinterpreting comorbidity: a model-based approach to understanding and classifying psychopathology. Ann Rev Clin Psychol. 2006;2(1):111133.
10.Rodriguez-Seijas, C, Eaton, NR, Krueger, RF. How transdiagnostic factors of personality and psychopathology can inform clinical assessment and intervention. J Pers Assess. 2015;97(5):425435.
11.Dalley, JW, Everitt, BJ, Robbins, TW Impulsivity, compulsivity, and top-down cognitive control. Neuron. 2011;69(4):680694.
12.Moeller, FG, Barratt, ES, Dougherty, DM, Schmitz, JM, Swann, AC. Psychiatric aspects of impulsivity. Am J Psychiatry. 2001;158(11):17831793.
13.Hollander, E. Obsessive-compulsive spectrum disorders: an overview. Psychiatr Ann. 1993;23(7):355358.
14.Hollander, E, Benzaquen, DS. The obsessive compulsive spectrum disorders. Int Rev Psychiatry. 1997;9(1):99110.
15.Grant, JE, Kim, SW. Comorbidity of impulse control disorders in pathological gamblers. Acta Psychiatr Scand. 2003;108(3):203207.
16.Black, DW, Coryell, W, Crowe, R, Shaw, M, McCormick, B, Allen, J. The relationship of DSM-IV pathological gambling to compulsive buying and other possible spectrum disorders: results from the Iowa PG family study. Psychiatry Res. 2015;226(1):273276.
17.Ruscio, AM, Stein, DJ, Chiu, WT, Kessler, RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):5363.
18.Chamberlain, SR, Stochl, J, Redden, SA, Grant, JE. Latent traits of impulsivity and compulsivity: toward dimensional psychiatry. Psychol Med. 2017;48(5):112.
19.Gillan, CM, Kosinski, M, Whelan, R, Phelps, EA, Daw, ND. Characterizing a psychiatric symptom dimension related to deficits in goal-directed control. eLife. 2016;5:e11305.
20.Cyders, MA, Coskunpinar, A. Measurement of constructs using self-report and behavioral lab tasks: is there overlap in nomothetic span and construct representation for impulsivity? Clin Psychol Rev. 2011;31(6):965982.
21.Hedge, C, Powell, G, Sumner, P. The reliability paradox: why robust cognitive tasks do not produce reliable individual differences. Behav Res Methods. 2018;50(3):11661186.
22.Cyders, MA, Smith, GT, Spillane, NS, Fischer, S, Annus, AM, Peterson, C. Integration of impulsivity and positive mood to predict risky behavior: development and validation of a measure of positive urgency. Psychol Assess. 2007;19(1):107118.
23.Whiteside, SP, Lynam, DR. The Five Factor Model and impulsivity: using a structural model of personality to understand impulsivity. Personality and Individual Differences. 2001;30(4):669689.
24.Stanford, MS, Mathias, CW, Dougherty, DM, Lake, SL, Anderson, NE, Patton, JH. Fifty years of the Barratt Impulsiveness Scale: an update and review. Personality and Individual Differences. 2009;47(5):385395.
25.Tolin, DF, Abramowitz, JS, Brigidi, BD, Foa, EB. Intolerance of uncertainty in obsessive-compulsive disorder. J Anxiety Disord. 2003;17(2):233242.
26.Gentes, EL, Ruscio, AM. A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clin Psychol Rev. 2011;31(6):923933.
27.Obsessive Compulsive Cognitions Working Group. Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory. Part 2: factor analyses and testing of a brief version. Behav Res Ther. 2005;43(11):15271542.
28.Chamberlain, SR, Leppink, EW, Redden, SA, Grant, JE. Are obsessive–compulsive symptoms impulsive, compulsive or both? Compr Psychiatry. 2016;68(Suppl C):111118.
29.Gillan, CM, Daw, ND. Taking psychiatry research online. Neuron 2016;91(1):1923.
30.Reise, SP. The rediscovery of bifactor measurement models. Multivariate Behav Res. 2012;47(5):667696.
31.Myers, SG, Fisher, PL, Wells, A. Belief domains of the Obsessive Beliefs Questionnaire-44 (OBQ-44) and their specific relationship with obsessive-compulsive symptoms. J Anxiety Disord. 2008;22(3):475484.
32.Carleton, RN, Norton, MA, Asmundson, GJ. Fearing the unknown: a short version of the Intolerance of Uncertainty Scale. J Anxiety Disord. 2007;21(1):105117.
33.Birrell, J, Meares, K, Wilkinson, A, Freeston, M. Toward a definition of intolerance of uncertainty: a review of factor analytical studies of the Intolerance of Uncertainty Scale. Clin Psychol Rev. 2011;31(7):11981208.
34.Saunders, JB, Aasland, OG, Babor, TF, De La Fuente, JR, Grant, M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993;88(6):791804.
35.Holtgraves, T. Evaluating the problem gambling severity index. J Gambl Stud. 2009;25(1):105120.
36.Faber, RJ, O’Guinn, TC. A clinical screener for compulsive buying. Journal of Consumer Research. 1992 ; 19(3):459469.
37.Foa, EB, Huppert, JD, Leiberg, S, et al. The Obsessive-Compulsive Inventory: development and validation of a short version. Psychol Assess. 2002;14(4):485496.
38.Gormally, J, Black, S, Daston, S, Rardin, D. The assessment of binge eating severity among obese persons. Addict Behav. 1982;7(1):4755.
39.Caplan, SE. Problematic Internet use and psychosocial well-being: development of a theory-based cognitive-behavioral measurement instrument. Computers in Human Behavior. 2002;18(5):553575.
40.Caplan, SE. Theory and measurement of generalized problematic internet use: a two-step approach. Computers in Human Behavior. 2010;26(5):10891097.
41.Reinert, DF, Allen, JP. The Alcohol Use Disorders Identification Test: an update of research findings. Alcohol Clin Exp Res. 2007;31(2):185199.
42.Reinert, DF, Allen, JP. The Alcohol Use Disorders Identification Test (AUDIT): a review of recent research. Alcohol Clin Exp Res. 2002;26(2):272279.
43.Müller, A, Mitchell, JE, de Zwaan, M. Compulsive buying. Am J Addict. 2015;24(2):132137.
44.Duarte, C, Pinto-Gouveia, J, Ferreira, C. Expanding binge eating assessment: validity and screening value of the Binge Eating Scale in women from the general population. Eat Behav. 2015;18:4147.
45.Laconi, S, Rodgers, RF, Chabrol, H. The measurement of Internet addiction: a critical review of existing scales and their psychometric properties. Computers in Human Behavior. 2014;41(Suppl C):190202.
46.Abramowitz, JS, Deacon, BJ. Psychometric properties and construct validity of the Obsessive–Compulsive Inventory—Revised: replication and extension with a clinical sample. J Anxiety Disord. 2006;20(8):10161035.
47.Yim, O, Ramdeen, KT. Hierarchical cluster analysis: comparison of three linkage measures and application to psychological data. The Quantitative Methods for Psychology. 2015;11(1):821.
48.Muthén, LK, Muthén, BO. Mplus user’s guide . 7th ed. Los Angeles, CA: Muthén & Muthén; 1998–2012.
49.Enders, CK. Applied Missing Data Analysis . New York: The Guilford Press; 2010.
50.Byrne, BM. Structural Equation Modeling with Mplus: Basic Concepts, Applications, and Programming . New York: Routledge; 2012.
51.Kline, RB. Principles and Practice of Structural Equation Modeling. 4th ed. New York: The Guilford Press; 2016.
52.Vandenberg, RJ, Lance, CE. A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research. Organizational Research Methods. 2000;3(1):470.
53.Silvia, ESM, MacCallum, RC. Some factors affecting the success of specification searches in covariance structure modeling. Multivariate Behav Res. 1988;23(3):297326.
54.Devlieger, I, Rosseel, Y. Factor score path analysis. Methodology. 2017;13(Suppl 1):3138.
55.Devlieger, I, Mayer, A, Rosseel, Y. Hypothesis testing using factor score regression: a comparison of four methods. Educ Psychol Meas. 2016;76(5):741770.
56.Bagozzi, RP, Yi, Y. Specification, evaluation, and interpretation of structural equation models. Journal of the Academy of Marketing Science. 2012;40(1):834.
57.Marsh, HW, Hau, KT, Wen, Z. In search of golden rules: comment on hypothesis-testing approaches to setting cutoff values for fit indexes and dangers in overgeneralizing Hu and Bentler’s (1999) findings. Structural Equation Modeling. 2004;11(3):320341.
58.Bentler, PM, Bonett, DG. Significance tests and goodness of fit in the analysis of covariance structures. Psychol Bull. 1980;88(1):588606.
59.Browne, MW, Cudeck, R. Alternative ways of assessing model fit. In: Bollen KA, Long JS, eds. Testing Structural Equation Models. Newbury Park, CA: Sage; 1993:136162.
60.Yu, C-Y. Evaluating Cutoff Criteria of Model Fit Indices for Latent Variable Models with Binary and Continuous Outcomes [dissertation]. Los Angeles: University of California Los Angeles; 2002.
61.Hoaglin, DC, Iglewicz, B. Fine-tuning some resistant rules for outlier labeling. Journal of the American Statistical Association. 1987;82(400):11471149.
62.Small, NJH. Marginal skewness and kurtosis in testing multivariate normality. Journal of the Royal Statistical Society. Series C (Applied Statistics). 1980;29(1):8587.
63.Looney, SW. How to use tests for univariate normality to assess multivariate normality. The American Statistician. 1995;49(1):6470.
64.DeCarlo, LT. On the meaning and use of kurtosis. Psychol Methods. 1997;2(3):292307.
65.Kuss, DJ, Griffiths, MD, Karila, L, Billieux, J. Internet addiction: a systematic review of epidemiological research for the last decade. Curr Pharm Des. 2014;20(25):40264052.
66.Byrne, BM, Shavelson, RJ, Muthén, B. Testing for the equivalence of factor covariance and mean structures: the issue of partial measurement invariance. Psychol Bull. 1989;105(3):456466.
67.Whiteside, SP, Lynam, DR, Miller, JD, Reynolds, SK. Validation of the UPPS impulsive behaviour scale: a four-factor model of impulsivity. European Journal of Personality. 2005;19(7):559574.
68.Rodriguez, A, Reise, SP, Haviland, MG. Applying bifactor statistical indices in the evaluation of psychological measures. J Pers Assess . 2016;98(3):223237.
69.Reise, SP, Waller, NG. Item response theory and clinical measurement. Annu Rev Clin Psychol. 2009;5:2748.
70.Rodriguez, A, Reise, SP, Haviland, MG. Evaluating bifactor models: calculating and interpreting statistical indices. Psychol Methods. 2016;21(2):137150.
71.Hancock, GR, Mueller, RO. Rethinking construct reliability within latent variable systems. In: Cudeck R, du Toit S, Sorbom D, eds. Structural Equation Modeling: Present and Future—A Festchrift in Honor of Karl Joreskog. Lincolnwood, IL: Scientific Software International; 2001:195216.
72.Edelen, MO, Reeve, BB. Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement. Qual Life Res. 2007;16(Suppl 1):518.
73.Reise, SP, Scheines, R, Widaman, KF, Haviland, MG. Multidimensionality and structural coefficient bias in structural equation modeling a bifactor perspective. Educational and Psychological Measurement. 2013;73(1):526.
74.Steinmetz, H. Analyzing observed composite differences across groups is partial measurement invariance enough? Methodology: European Journal of Research Methods for the Behavioral and Social Sciences. 2013;9(1):112.
75.Grice, JW. Computing and evaluating factor scores. Psychol Methods. 2001;6(4):430450.
76.DiStefano, C, Zhu, M, Mindrila, D. Understanding and using factor scores: considerations for the applied researcher. Practical Assessment, Research & Evaluation. 2009;14(20):111.
77.Hollander, E, Rosen, J. Impulsivity. J Psychopharmacol. 2000;14(2 Suppl 1):S39S44.
78.Berlin, GS, Hollander, E. Compulsivity, impulsivity, and the DSM-5 process. CNS Spectr. 2014;19(1):6268.
79.Kircanski, K, White, LK, Tseng, WL, et al. A latent variable approach to differentiating neural mechanisms of irritability and anxiety in youth. JAMA Psychiatry. 2018;75(6):631639.
80.Coskunpinar, A, Dir, AL, Cyders, MA. Multidimensionality in impulsivity and alcohol use: a meta-analysis using the UPPS model of impulsivity. Alcohol Clin Exp Res. 2013;37(9):14411450.
81.Norbury, A, Husain, M. Sensation-seeking: dopaminergic modulation and risk for psychopathology. Behav Brain Res. 2015;288(Suppl C):7993.
82. Hittner, JB, Swickert, R. Sensation seeking and alcohol use: a meta-analytic review. Addict Behav. 2006;31(8):13831401.
83.Mahoney, AEJ, McEvoy, PM. A transdiagnostic examination of intolerance of uncertainty across anxiety and depressive disorders. Cogn Behav Ther. 2012;41(3):212222.
84.Carleton, RN, Mulvogue, MK, Thibodeau, MA, McCabe, RE, Antony, MM, Asmundson GJG. Increasingly certain about uncertainty: intolerance of uncertainty across anxiety and depression. J Anxiety Disord. 2012;26(3):468479.
85.Eaton, NR, Rodriguez-Seijas, C, Carragher, N, Krueger, RF. Transdiagnostic factors of psychopathology and substance use disorders: a review. Soc Psychiatry Psychiatr Epidemiol. 2015;50(2):171182.
86.Fontenelle, LF, Oostermeijer, S, Harrison, BJ, Pantelis, C, Yücel, M. Obsessive-compulsive disorder, impulse control disorders and drug addiction. Drugs. 2011;71(7):827840.
87.Boswell, JF, Thompson-Hollands, J, Farchione, TJ, Barlow, DH. Intolerance of uncertainty: a common factor in the treatment of emotional disorders. J Clin Psychol. 2013;69(6):630645.
88.Einstein, DA. Extension of the transdiagnostic model to focus on intolerance of uncertainty: a review of the literature and implications for treatment. Clin Psychol (New York). 2014;21(3):280300.
89.Stahl, C, Voss, A, Schmitz, F,. Behavioral components of impulsivity. J Exp Psychol Gen. 2014;143(2):850886.
90.Grant, JE, Kim, SW. Brain circuitry of compulsivity and impulsivity. CNS Spectr. 2013;19(1):2127.
91.Bonifay, W, Lane, SP, Reise, SP. Three concerns with applying a bifactor model as a structure of psychopathology. Clinical Psychological Science. 2017;5(1):184186.
92.Skrondal, A, Laake, P. Regression among factor scores. Psychometrika. 2001;66(4):563575.
93.Marsh, HW, Lüdtke, O, Nagengast, B, AJS, Morin, Von Davier, M. Why item parcels are (almost) never appropriate: Two wrongs do not make a right—Camouflaging misspecification with item parcels in CFA models. Psychol Methods. 2013;18(3):257284.
94.Bandalos, DL. The effects of item parceling on goodness-of-fit and parameter estimate bias in structural equation modeling. Structural Equation Modeling: A Multidisciplinary Journal. 2002;9(1):78102.


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Overlapping dimensional phenotypes of impulsivity and compulsivity explain co-occurrence of addictive and related behaviors

  • Jeggan Tiego (a1), Sanne Oostermeijer (a1) (a2), Luisa Prochazkova (a1) (a3), Linden Parkes (a1), Andrew Dawson (a1), George Youssef (a1) (a4) (a5), Erin Oldenhof (a1), Adrian Carter (a1), Rebecca A. Segrave (a1), Leonardo F. Fontenelle (a1) (a6) (a7) and Murat Yücel (a1)...


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